=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588034219
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APC HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2015
-----------------------------------------------------
Last Update Date | 02/09/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2817 MILLER RANCH RD SUITE 317
-----------------------------------------------------
City | PEARLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77584-9721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-772-6690
-----------------------------------------------------
Fax | 713-774-3498
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 JEFFERSON ST STE 404
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70501-6991
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-772-6690
-----------------------------------------------------
Fax | 888-978-5266
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | ROHAN NATH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-772-2132
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------